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The impact of acquired coagulation factor XIII deficiency in traumatic bleeding and wound healing. Crit Care 2022; 26:69. [PMID: 35331308 PMCID: PMC8943792 DOI: 10.1186/s13054-022-03940-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Factor XIII (FXIII) is a protein involved in blood clot stabilisation which also plays an important role in processes including trauma, wound healing, tissue repair, pregnancy, and even bone metabolism. Following surgery, low FXIII levels have been observed in patients with peri-operative blood loss and FXIII administration in those patients was associated with reduced blood transfusions. Furthermore, in patients with low FXIII levels, FXIII supplementation reduced the incidence of post-operative complications including disturbed wound healing. Increasing awareness of potentially low FXIII levels in specific patient populations could help identify patients with acquired FXIII deficiency; although opinions and protocols vary, a cut-off for FXIII activity of ~ 60–70% may be appropriate to diagnose acquired FXIII deficiency and guide supplementation. This narrative review discusses altered FXIII levels in trauma, surgery and wound healing, diagnostic approaches to detect FXIII deficiency and clinical guidance for the treatment of acquired FXIII deficiency.
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Song Y, Li Y, Xiao Y, Hu W, Wang X, Wang P, Zhang X, Yang J, Huang Y, He W, Huang C. Neutralization of interleukin-17A alleviates burn-induced intestinal barrier disruption via reducing pro-inflammatory cytokines in a mouse model. BURNS & TRAUMA 2019; 7:37. [PMID: 31890716 PMCID: PMC6933641 DOI: 10.1186/s41038-019-0177-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023]
Abstract
Background The intestinal barrier integrity can be disrupted due to burn injury, which is responsible for local and systemic inflammatory responses. Anti-inflammation strategy is one of the proposed therapeutic approaches to control inflammatory cascade at an early stage. Interleukin-17A (IL-17A) plays a critical role in inflammatory diseases. However, the role of IL-17A in the progression of burn-induced intestinal inflammation is poorly understood. In this study, we aimed to investigate the effect of IL-17A and associated pro-inflammatory cytokines that were deeply involved in the pathogenesis of burn-induced intestinal inflammatory injury, and furthermore, we sought to determine the early source of IL-17A in the intestine. Methods Mouse burn model was successfully established with infliction of 30% total body surface area scald burn. The histopathological manifestation, intestinal permeability, zonula occludens-1 expression, pro-inflammatory cytokines were determined with or without IL-17A-neutralization. Flow cytometry was used to detect the major source of IL-17A+ cells in the intestine. Results Burn caused intestinal barrier damage, increase of intestinal permeability, alteration of zonula occludens-1 expressions, elevation of IL-17A, IL-6, IL-1β and tumor necrosis factor-α (TNF-α), whereas IL-17A neutralization dramatically alleviated burn-induced intestinal barrier disruption, maintained zonula occludens-1 expression, and noticeably, inhibited pro-inflammatory cytokines elevation. In addition, we observed that the proportion of intestinal IL-17A+Vγ4+ T subtype cells (but not IL-17A+Vγ1+ T subtype cells) were increased in burn group, and neutralization of IL-17A suppressed this increase. Conclusions The main original findings of this study are intestinal mucosa barrier is disrupted after burn through affecting the expression of pro-inflammatory cytokines, and a protective role of IL-17A neutralization for intestinal mucosa barrier is determined. Furthermore, Vγ4+ T cells are identified as the major early producers of IL-17A that orchestrate an inflammatory response in the burn model. These data suggest that IL-17A blockage may provide a unique target for therapeutic intervention to treat intestinal insult after burn.
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Affiliation(s)
- Yajun Song
- 1Department of Urology, Xinqiao Hospital, the Third Military Medical University, No.83 Xinqiao Street, Shapingba District, Chongqing, 400038 China
| | - Yang Li
- 1Department of Urology, Xinqiao Hospital, the Third Military Medical University, No.83 Xinqiao Street, Shapingba District, Chongqing, 400038 China
| | - Ya Xiao
- 1Department of Urology, Xinqiao Hospital, the Third Military Medical University, No.83 Xinqiao Street, Shapingba District, Chongqing, 400038 China
| | - Wengang Hu
- 1Department of Urology, Xinqiao Hospital, the Third Military Medical University, No.83 Xinqiao Street, Shapingba District, Chongqing, 400038 China
| | - Xu Wang
- 1Department of Urology, Xinqiao Hospital, the Third Military Medical University, No.83 Xinqiao Street, Shapingba District, Chongqing, 400038 China
| | - Pei Wang
- 2Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Xiaorong Zhang
- 2Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Jiacai Yang
- 2Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Yong Huang
- 2Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Weifeng He
- 2Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Chibing Huang
- 1Department of Urology, Xinqiao Hospital, the Third Military Medical University, No.83 Xinqiao Street, Shapingba District, Chongqing, 400038 China
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